Why would my dentist recommend an oral biopsy?

Do you want to know what to expect from an oral biopsy and to understand why you need one in the first place? Today our dentists in Winnipeg break down what will happen at the procedure and explain why they are performed.

What is an oral biopsy?

An oral biopsy is a surgical procedure that takes tissue from the patient’s oral cavity to be examined, usually to help make a diagnosis.

Why a dentist might recommend an oral biopsy

If you have a lesion that interrupts your oral function, you could require a biopsy to find out the cause so a dentist can prescribe an effective method of treatment. There might also be inflammatory changes impacting the oral cavity or a bone lesion a dentist can't identify with X-rays or clinical examination.

A biopsy might also be completed if a dentist believes you have oral cancer (which could be found in the mouth, head, and neck). If you have already been diagnosed with cancer a biopsy might help determine the stage, extent, and source of the cancer.

Oral and maxillofacial surgeons diagnose and treat various illnesses, injuries, and conditions affecting the neck, jaw, face, and mouth. At your appointment, a thorough exam of your head and neck will be conducted and an oral biopsy will be performed. The surgeon or dentist might also refer you to a otolaryngoloist (an ear, nose, and throat doctor).

In an oral biopsy, a small sample of the suspicious tissue will be taken out of your oropharynx or mouth and sent to a pathologist, where it will be checked for disease. A custom treatment plan will then be developed depending on the information in the pathologist’s report.

Types of Oral Biopsies

The 6 types of oral biopsies include:

Aspiration Biopsy

A needle and syringe are used to remove a sample of cells or contents from a lesion. If the oral surgeon is not able to drain fluid or air, it may mean the lesion is solid.

Brush Biopsy

The surgeon applies firm pressure with a circular brush, rotating it to pick up cellular material that will later be transferred to a glass slide, preserved and dried.

Cytology

This type of oral biopsy aids in the diagnosis of lesions in the oral cavity. These lesions may be caused by infections, herpes or post-radiation changes.

Though individual cells can be examined, an accurate and definitive diagnosis may not be possible without an excisional or incisional biopsy also being performed.

Excisional Biopsy

Performed for small oral lesions (typically measuring less than 1 cm) that appear benign during a clinical exam, an excisional biopsy completely removes the lesion.

Incisional Biopsy

A surgeon will complete this type of biopsy to obtain a representative sample of the oral lesion. If your oral lesion is large or has differing characteristics, more than one area may need to be sampled.

Punch Biopsy

Best suited for diagnosing oral manifestations of ulcerative and mucocutaneous conditions of the oral cavity (such as lichen planus), a punch biopsy is completed using a punch tool.

How to prepare for an oral biopsy

You will not have to do much to prepare for your biopsy appointment. If the biopsy will be performed on part of a bone, a dentist could recommend X-rays or CT scans first and will ask you not to eat anything for a few hours before the biopsy.

After you have arrived, you’ll typically be asked to rinse with an antibacterial mouthwash. Local anesthesia is typically used and you will most likely be awake for the procedure. However, you might be given general anesthesia if the lesion is in an area of the mouth that’s difficult to reach.

Will an oral biopsy hurt?

You shouldn’t feel pain during the procedure – perhaps just a sharp pinprick or pinch as a local anesthetic is injected, or as the needle is used to take the biopsy. The use of instruments may also result in some minor pressure as the sample is collected.

After the anesthesia wears off, depending on where the biopsy was performed the site may feel sore for several days. You may want to stick to soft foods and take over-the-counter medication for pain (avoid taking NSAIDs, which can increase the risk for bleeding).

If you experience significant pain from the biopsy, you may be prescribed pain medications.

Do you have questions about your upcoming oral biopsy? Our Winnipeg dentists can address any inquiries or concerns.